Diagnostic accuracy (area under the curve) for heart failure was 0.89 (brain natriuretic peptide) and 0.88 (N-terminal pro-B-type natriuretic peptide); for pneumonia, CRP was 0.77 and PCT was 0.69.<h4>Discussion</h4>Breathlessness-related hospital admissions in Malawi are common, multifactorial and associated with poor survival. This evidence concerns the gene NPPB and pneumonia.